Alcohol consumption by American youth has stabilized, but is still too high

Alcohol is the number one ‘drug of choice’ for American children and adolescents.

Although drinking levels are down from their peak during the 1970s, new findings indicate no further declines during the past decade or so.

Drinking by youth remains at unacceptably high levels.

Alcohol is the number one ‘drug of choice’ for children and adolescents. Its use not only contributes to academic and social problems, risky sexual behavior, and motor vehicle crashes, it may also be a risk factor for the development of alcohol-related problems during adulthood. Findings published in the September issue of Alcoholism: Clinical & Experimental Research show that, even though levels of drinking are down from their peak during the 1970s, consumption levels among American youth remain unacceptably high.

"We examined data from three nationally representative data sets, each of which has information on drinking by youth," said Vivian B. Faden, associate director of the Division of Epidemiology and Prevention Research at the National Institute on Alcohol Abuse and Alcoholism and first author of the study. "In a sense, we are triangulating, in much the same way that a GPS system triangulates to determine location. We also used a sophisticated, recently developed technique called ‘joinpoint analysis’ to analyze drinking trends among youth over time. Our major finding is that since about 1990, rates of drinking by youth under the age of 18 have remained relatively stable. This is true if we look at any drinking or at binge drinking, which refers to consumption of five or more drinks in a row."

Researchers analyzed three data sets – "Monitoring the Future" for the years 1975 - 2002, the "Youth Risk Behavior Survey" for the years 1991 - 2001, and the "National Household Survey on Drug Abuse" for 1979, 1985, and 1991 - 2001 – for trends in drinking.

Results of the analysis indicate that the prevalence of alcohol consumption by youth 18 years of age and younger has decreased since the 1970s, becoming relatively stable for the last five to 10 years. However, prevalence rates for consumption continue to remain high for 8th through 12th grade students, and for youth between 12 and 17 years of age.

"Three large data sets are saying the same thing," said Faden, "which is more convincing than seeing the results from just one survey. Rates for any use in the past 30 days range from 19.6 percent of 8th graders to 48.6 percent of 12th graders. Rates for drinking five or more drinks in a row in the past two weeks ranged from 12.4 percent of 8th graders to 28.6 percent of 12th graders. These results support other findings of high rates of consumption in this population, but not cited in the paper, that nearly two-thirds of 12th graders, one-quarter of 10th graders and nearly one-fifth of 8th graders report already having been drunk at some point in their lives."

"Prevalence of alcohol use among youth remains at very high levels, suggesting quite clearly the need for new and more-focused approaches to reductions in alcohol use," said Michael Windle, professor of psychology and director of the Center for the Advancement of Youth Health at the University of Alabama at Birmingham. "This is of major concern because of associations with mortality, such as fatal automobile accidents, homicide, and suicide, as well as morbidity, meaning sexual activity, sexually transmitted diseases, and pregnancy. In addition, research findings in neuroimaging studies indicate that alcohol use among youth impairs brain functioning, specifically the hippocampus which is critical to learning and memory.

"Certainly we have done some things right," noted Faden. "Rates of consumption are down from their high point in the 70s. To some extent this is a reflection of changes in minimum drinking age laws, but it is also a reflection of prevention efforts. Worrisome is the fact that rates seem to have stabilized in the past decade at quite high rates, rather than continuing to move downward. This leads one to wonder if somehow our current armamentarium of prevention tools needs to be upgraded in some way."

"Two directions for future research now seem important," said Windle. "First, greater knowledge is needed regarding changes in alcohol use by youth across time and what predicts those changes. This is important in order to be able to distinguish who will be an experimental user from who is likely to become a person with serious alcohol problems or to develop an alcohol disorder. Second, on the basis of knowledge obtained by the first direction, interventions could be developed that correspond with factors that predict future serious alcohol problems, and interventions may vary in their intensity – that is, in frequency or duration – across adolescents contingent on risk profiles."

"Clearly we need to enhance our understanding of the phenomenon and re-examine the approaches we have taken to impact it," said Faden. "Hopefully, in another ten years, we can report a downturn in this high-prevalence behavior, instead of a stable situation."

Funding for this Addiction Science Made Easy project is provided by the Addiction Technology Transfer Center National Office, under the cooperative agreement from the Center for Substance Abuse Treatment of SAMHSA.